Parental consent and school based clinics

As my two eldest daughters venture into the world of tweens, I find myself becoming ever more cautious about what they are seeing, hearing and talking about.  My husband and I are thinking about the next few years and all that they will be exposed to, knowing that it will be so much more than when we were that age. It worries us, as I’m sure it worries many other good parents.

And so, this morning when I read yet another story of health services undermining the authority of parents, my maternal lioness instinct kicked in big time.

The story was of a Northland mother whose 13-year-old daughter came home explaining that she had been fitted with a Jadelle contraceptive implant.  The whole procedure was done by the Adolescent Health Clinic adjacent to the High School, all without the knowledge or consent of her parents.

The Adolescent Health Clinic is one of three that are either school-based or adjacent to High Schools in Northland.  The clinics are run by the Te Tai Tokerau PHO.  Youth in Kawakawa, Taipa and Kaitaia all have access to these clinics whose objective is

to provide accessible integrated youth focused and friendly services that target priority health issues impacting on the health of young people; in particular sexual health, mental health and family planning.

Yes, that’s right sexual health is the main point of these clinics.  The purpose is to provide a parent-free zone where confidentiality is ensured and sexual activity (of any kind) is encouraged, even if the young person is below the age of consent.  Contraception is provided, and when that fails, STD checks and abortion referrals are the solutions given.

Lest people outside of these areas feel compelled to breathe a sigh of relief that the clinics are not near their schools, it should be noted that there are plenty more school based health clinics throughout New Zealand, which identify “sexual health” as being a top issue.

The mother in our story was outraged at being left out of such a critical decision in her daughter’s care, and rightly so.  Her daughter, only 13 (and therefore legally unable to consent to sexual intercourse) was able to attend the clinic and receive an implant in her arm that releases hormones into her system 24/7.

Deeply concerned about the situation the mother raised the following issues:

1.  Parental consent is required for school trips and dental procedures and vaccines, yet a minor can be prescribed contraception or be referred for an abortion without the parents knowledge or consent.

2.  Restrictions are made regarding the appropriate age to drive a car, drink or buy tobacco.  It is recognised that all of these things have an element of risk to them and good decision-making skills are required.  We hope, that by restricting the age that one can drive or drink or smoke, better, more mature decisions will be made around these things.

3.  Family medical history is not known by the clinic.  In this story, the family medical history was not accessed by the clinic.  How were they to know that one of the contraindications to using Jadelle were not present or that the girl was more susceptible to certain conditions?

I’d like to add the following points:

4.  Hormones are released 24/7.  What effect does this have on a growing girl?  How will it effect her fertility?  How does it effect her on-going moods?  The clinical trials were only undertaken on women aged 18 to 40.  Use in teens younger than 18 is purely experimental and the long term effects cannot at this stage be known.

5.  Children under the age of 16 are unable to consent to sexual intercourse – it is statutory rape.  By eliminating the family from any decisions, the staff are enabling the abuser to continue on in secret.  Even if the under 16-year-old is a willing participant, the law is still being broken and parents should have the right to know what is going on in their child’s life.

6.  Risky behaviour is encouraged.  Inserting a Jadelle contraceptive implant does not protect a young girl from STDs, a broken heart, depression and suicide.  The implant is a free ticket to multiple sexual partners and leaves a young girl open to use and abuse by boys and men who apparently no longer have the consequence of pregnancy to consider.

7.  Breaks down the family by discouraging communication.  By leaving out the family, medical professionals are encouraging secrecy and disrespect of the young person’s parents.  Youth should be encouraged to discuss these matters with their parents, or a close family friend who understands the morals and expectations of the family.  Rather than leaving parents out, the very least any professionals can do, is provide a mediated discussion of sensitive issues.

In the end, the 13-year-old girl had the Jadelle implant removed, not because her parents requested it, but because she requested it herself (parents can’t legally request for the implant to be removed).  Thankfully, this family had a good talking relationship where the daughter felt she could tell her mother about the implant.  What would have happened if she hadn’t?

How many other young girls out there are receiving contraception of all kinds from these clinics without their parents knowledge?  How many are being sent off for abortions without their parents knowledge?

There is a lesson for parents to be learnt in this story.  We need to take charge of our children’s lives, not in an overbearing, controlling way.  But we do need to listen to them, spend time with them, encourage them in activities that build them up and keep them busy.  We need to be aware of what “services” might be provided in and around school and which organisations associate themselves with education providers and even groups like Scouts and Girl Guides.  We do need to be aware of what our children are reading, viewing and listening to.  We need to ensure that we are approachable and give kind and thoughtful, but firm guidance when required.

On another level, we must not be content to sit back and let schools and organisations take the lead.  We need to know exactly what is happening at school.  Where we can, we must be involved politically and stand up for our rights as parents to bring up our children to be responsible and mature citizens that understand that all actions have consequences for which we must take responsibility.  As parents we must not abdicate our responsibility to be the first teachers of our children.  We cannot give our children over to those who seek to destroy the family.